{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:25:50Z","timestamp":1792797950528,"version":"4.5.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors sought to identify the relevance between pneumocephalus and postoperative intracranial infections, as well as bacteriological characteristics and risk factors for intracranial infections, in patients with pituitary adenomas after endoscopic endonasal transsphenoidal surgery.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In total, data from 251 consecutive patients with pituitary adenomas who underwent pure endoscopic endonasal transsphenoidal surgeries from 2014 to 2018 were reviewed for preoperative comorbidities, intraoperative techniques, and postoperative care.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n This retrospective study found 18 cases of postoperative pneumocephalus (7.17%), 9 CNS infections (3.59%), and 12 CSF leaks (4.78%). Of the patients with pneumocephalus, 5 (27.8%) had CNS infections. In patients with CNS infections, the culture results were positive in 7 cases and negative in 2 cases. The statistical analysis suggested that pneumocephalus (maximum bubble diameter of \u2265 1 cm), diaphragmatic defects (intraoperative CSF leak, Kelly grade \u2265 1), and a postoperative CSF leak are risk factors for postoperative CNS infections.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In pituitary adenoma patients who underwent pure endoscopic endonasal transsphenoidal surgeries, intraoperative saddle reconstruction has a crucial role for patients with postoperative intracranial infections. Additionally, postoperative pneumocephalus plays an important role in predicting intracranial infections that must not be neglected. Therefore, neurosurgeons should pay close attention to the discovery of postoperative intracranial pneumocephalus because this factor is as important as a postoperative CSF leak. Pneumocephalus (maximum bubble diameter of \u2265 1 cm), diaphragmatic defects (an intraoperative CSF leak, Kelly grade \u2265 1), and a postoperative CSF leak were risk factors predictive of postoperative intracranial infections. In addition, it is essential that operative procedures be carefully performed to avoid diaphragmatic defects, to reduce exposure to the external environment, and to decrease patients\u2019 suffering.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2019.5.focus19269","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T19:18:28Z","timestamp":1564773508000},"page":"E5","source":"Crossref","is-referenced-by-count":27,"title":["Risk factors for postoperative intracranial infections in patients with pituitary adenoma after endoscopic endonasal transsphenoidal surgery: pneumocephalus deserves further study"],"prefix":"10.3171","volume":"47","author":[{"given":"Kang","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi\u2019an, Shaanxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Heng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi\u2019an, Shaanxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haihong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi\u2019an, Shaanxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi\u2019an, Shaanxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Genetic Engineering and Ministry of Education, College of Life Sciences, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi\u2019an, Shaanxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"961","DOI":"10.3171\/2014.5.JNS132028","article-title":"Pneumocephalus patterns following endonasal endoscopic skull base surgery as predictors of postoperative CSF leaks","volume":"121","author":"Banu MA","year":"2014","unstructured":"Banu MA, Szentirmai O, Mascarenhas L, Salek AA, Anand VK, Schwartz TH: Pneumocephalus patterns following endonasal endoscopic skull base surgery as predictors of postoperative CSF leaks. 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